Details

Autor(en) / Beteiligte

• Knijnenburg, Sebastiaan L
• Jaspers, Monique W
• van der Pal, Helena J
• Schouten-van Meeteren, Antoinette Y
• Bouts, Antonia H
• Lieverst, Jan A
• Bökenkamp, Arend
• Koning, Caro C E
• Oldenburger, Foppe
• Wilde, James C H
• van Leeuwen, Flora E
• Caron, Huib N
• Kremer, Leontien C

Titel

Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors

Ist Teil von

• Clinical journal of the American Society of Nephrology, 2012-09, Vol.7 (9), p.1416-1427

Ort / Verlag

United States: American Society of Nephrology

Erscheinungsjahr

2012

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Little is known about renal function and blood pressure (BP) in long-term childhood cancer survivors. This cross-sectional study evaluated prevalence of these outcomes and associated risk factors in long-term childhood cancer survivors at their first visit to a specialized outpatient clinic. Estimated GFR; percentages of patients with albuminuria, hypomagnesemia, and hypophosphatemia; and BP were assessed in 1442 survivors ≥5 years after diagnosis. Multivariable logistic regression analyses were used to estimate effect of chemotherapy, nephrectomy, and radiation therapy on the different outcomes. At a median age of 19.3 years (interquartile range, 15.6-24.5 years), 28.1% of all survivors had at least one renal adverse effect or elevated BP. The median time since cancer diagnosis was 12.1 years (interquartile range, 7.8-17.5 years). High BP and albuminuria were most prevalent, at 14.8% and 14.5%, respectively. Sixty-two survivors (4.5%) had an estimated GFR <90 ml/min per 1.73 m(2). Survivors who had undergone nephrectomy had the highest risk for diminished renal function (odds ratio, 8.6; 95% confidence interval [CI], 3.4-21.4). Combined radiation therapy and nephrectomy increased the odds of having elevated BP (odds ratio, 4.92; 95% CI, 2.63-9.19), as did male sex, higher body mass index, and longer time since cancer treatment. Almost 30% of survivors had renal adverse effects or high BP. Therefore, monitoring of renal function in high-risk groups and BP in all survivors may help clinicians detect health problems at an early stage and initiate timely therapy to prevent additional damage.